Isolated Perforation of Left Coronary Cusp after Blunt Chest Trauma

Abstract

Left coronary cusp perforation is an extremely rare consequence of blunt chest trauma. A 22-year-old male presented after a motor vehicle accident with dyspnea. Transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) showed moderate to severe aortic regurgitation with prolapsing right coronary cusp. In the operating room he was found to have a left coronary cusp tear near the annulus and an enlarged right cusp. The patient recovered well after successful aortic valve replacement with a mechanical valve. Traumatic aortic regurgitation with left cusp perforation is serious and surgical intervention may be lifesaving if performed timely.

Iatrogenic Acute Aortic Insufficiency Following Mitral Valve Replacement

“…Due to anatomical proximity, the most commonly affected cusps during mitral valve surgeries are the noncoronary and left coronary cusps; it rarely affects the right coronary cusp [3]. Aortic valve injury has also been reported following blunt chest trauma, percutaneous coronary intervention, Impella device placement, ventricular septal defect repair, atrial septal defect repair, and left ventricular septal myectomy [4,5].…”